2012-2013R

NUPACE APPLICATION CHECKLIST

NB. All applicants are required to register at: http://www.ecis.nagoya-u.ac.jp/nupace Have you registered at http://www.ecis.nagoya-u.ac.jp/nupace?

Please ensure that the following documents are enclosed in your application: NUPACE Application Form Contract Study Plan/Description of Academic Interests (typed on a separate sheet of A4-sized paper. Refer to Q.13 of NUPACE Application Form.) Official Transcript of Academic Records (to be issued in English by institution presently being attended) NB. 1) Graduate students should submit academic records for both undergraduate and graduate studies. 2) Transfer students should submit academic records for all institutions attended. Confidential Reference Form (to be written by a faculty member in an academic field related to the applicants major) Language Proficiency Form & Supporting Documents (i.e., TOEFL, IELTS, TOEIC and/or Japanese Language Proficiency Test <JLPT> score sheets) Certificate of Enrolment of the Applicant for Student Exchange Support Program (Scholarship for Short-term Study in Japan) (to be filled out and signed by an authorized person of the applicants home institution) Official Certificate of Enrolment as a Student (to be issued by the institution presently being attended) Health Certificate Personal Data Sheet Copy of the information page of the students passport, where available Four identical photographs (3.5 cm x 4.5 cm), signed on the reverse side, one of which should be attached to the NUPACE Application Form Statement of Bank Account Balance (This requirement applies to those students who wish to participate in NUPACE if their application for a JASSO scholarship is unsuccessful <see Q.12 of NUPACE Application Form>. Students applying for a one-semester exchange should enclose a bank balance verifying that they have funds equivalent to JPY500,000; students applying for a one-year exchange need to verify that they have JPY1,000,000. The bank account may be held in the name of the applicant, or a close family member.)

Application Deadlines: Completed application materials must reach the NUPACE Office by the following dates: Late September Admission 2012: Early April Admission 2013: Thursday, 15 March 2012 Thursday, 1 November 2012

Forwarding Address: NUPACE Office Education Center for International Students Nagoya University C5-1 (760) Furo-cho, Chikusa-ku 464-8601 JAPAN Enquiries: E-mail: nupace@ecis.nagoya-u.ac.jp Fax: +81 52 789 4201 Tel: +81 52 789 5457/5406/5405 Website: http://nupace.ecis.nagoya-u.ac.jp/en/index.shtml

Flow Chart of NUPACE Application Procedures for 2012-2013 Admissions

<Autumn Admission>
Applicant NUPACE Office Applicant

<Spring Admission>
NUPACE Office

Submission of application materials (deadline: March 15)

Submission of application materials (deadline: November 1) Admission decision (sent in mid-January by e-mail)

Admission decision (sent in mid-May by e-mail)

Confirmation of intent to participate (by early June)

Confirmation of intent to participate (by late January)

Pre-arrival information Result of scholarship (sent in early July by e-mail)

Pre-arrival information (sent in early February by e-mail)

Confirmation of contact details (by mid-July)

Confirmation of contact details (by mid February)

Admission Packet (sent in late July by post)

Admission packet (sent in mid-February by post)

Notification of travel itinerary (by mid-August)

Notification of travel itinerary (by early March)

Housing information (sent in early September by e-mail)

Housing information (sent in late February by e-mail)

Result of scholarship (TBA)

2012-2013

NUPACE Application Form

Affix photograph (3.5 cm x 4.5 cm) taken within last three months. The photograph should be taken directly from the front, and show the applicants head and shoulders. No headwear is permitted.

* TYPE or PRINT all information in Roman letters and Arabic numerals.

Applications filled out by pencil will not be admitted.

1. 2. 4. 5. 6.

Name:

family name

) 3.

Chinese character(s)

given (including middle) name(s)

( /

Chinese character(s)

Sex: Male / Female Country of citizenship: Tel/Fax: Current university & faculty/department:

Date of birth:
year

/
month

day

E-mail:

7. 8.

Major at university: List all institutions of higher education attended in order of most recent institution. Transcripts for all institutions must be enclosed with your application.
Date of attendance Major Qualification

Name of institution

~ ~ 9. Prospective affiliation (School) at Nagoya University, corresponding to your major field of study. Refer to the School/Department List enclosed: 1st Choice: 2nd Choice:

10. Prospective student status. Refer to the NUPACE prospectus (p. 3)/NUPACE website (http://www.ecis.nagoya-u.ac.jp/en/nupace/academic/status.html) and check one:
Special Undergraduate Student Special Graduate Student Special Research Student (NB. Applicants pursuing doctorates will automatically be placed in this category)

11.

Planned period of enrolment at Nagoya University. Check one:

Autumn Semester Only (Semester dates: Late September ~ Early February Autumn & Spring Semesters (Semester dates: Late September ~ Early August Spring Semester Only (Semester dates: Early April ~ Early August Spring & Autumn Semesters (Semester dates: Early April ~ Early February

12.

Specify your intended period of residence in Japan, taking into account academic requirements at your home institution (semester dates, summer school, graduation date, etc). From Late Sep 2012 / Early Apr 2013 (circle one) to (mo.) /
(yr.) (The student status of applicants intending to leave Nagoya University at the end of the spring semester will be valid until August 31st.)

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13. Are you willing to participate in NUPACE if your application for a Student Exchange Support Program Scholarship for Short-term Study in Japan is unsuccessful? Applicants circling yes are required to attach a statement of bank account balance to their application (see NUPACE Application Checklist for more details).

Yes

No

14.

Using a separate sheet of A4-sized paper, provide a concrete description of your academic interests and plan of study whilst at Nagoya University. (English: Minimum 400 words, typed. Japanese: Minimum 800 characters, typed) Applicants intending to study courses listed under the NUPACE academic programme should underline the course(s) that they are interested in taking:
Japanese Language (Intensive Course) Japanese Language (Standard Course) Kanji 1000/2000 Business Japanese I/II/III Global Society I (*J) Intro to Japanese Language & Culture II (*J) Intro to Japanese Linguistics I (*J) Intro to Japanese Society & Culture I (*J) Intro to Linguistics I (*J) A Multi-cultural Approach to Contemporary Issues Sociology of Education: Equity, Citizenship and Inclusion Teaching Practice in Japanese Community <GIS> Income Theory & Applications Introduction to Financial Reporting Law and Economics Workshops (S~A) Japans Development Experience Comparative Asian Legal Systems Educational Development Planning and Evaluation Human Security and Law Comparative Studies in Jurisprudence I Comparative Studies in Politics I Contemporary Japanese Diplomacy Contemporary Japanese Politics Introduction to Law Japanese Legal System Studies in Jurisprudence: Law as Political Theory I(S~A) Workshop on International Negotiation Yomiuri Shinbun Special Lecture-Corporate Asian Theory Outline of Japanese Culture since the 16th Century Regular Courses open to degree-seeking students (*J) Japanese Language (Intensive Course) Japanese Language (Standard Course) Kanji 1000/2000 Business Japanese I/II/III Intro to Japanese Language & Culture I (*J) Global Society II (*J) Intro to Japanese Linguistics II (*J) Intro to Japanese Society & Culture II (*J) Intro to Linguistics II (*J) Contemporary Japanese Society Introduction to Japanese Politics Immigration in Japan: A Socio-legal Perspectives Intercultural Education: Disney as Cultural Teacher Teaching Practice in Japanese Community <GIS> Development Economics Financial Accounting A Price Theory and Applications Law and Economics Workshops (S~A) Education in Japan Educational Development and Co-operation International Co-operation Law Introduction to International Development Law and Development Studies Guided Independent Study 1. 2.

15.

Autumn Semester:

Intro to Bioagricultural Sciences Academic, Scientific, and Technical English Advanced Lecture on the System Safety of Machinery Civil Engineering & Policies for Developing Countries I Intro to Civil Engineering & Architecture Motor Control & Info Processing in the Biological System (*G) Overview of Adv. Electric, Electronic & Information Engineering Science & Technology in Japan Biological Resources Management Policies Biological Resources Management Projects Climate Change Policies Environmental Industry Systems Planning & Design Studio for Historical Environment (*G) Politics and Diplomacy in International Environment (*G) Practice in Biological Resource Management Studio Workshop of Architecture Design (*G) Sustainability & Environmental Studies Water & Waste Engineering Perspectives in Mathematical Sciences Advanced Quantum Chemistry Computational Chemistry Clinical Practice (Clerkships) Basic Research Laboratory Experience (Medicine) Public Health Research Laboratory Experience (Medicine) A History of Japanese Chinema Japanese Culture: Language and Communication II Introduction to Sociolinguistics a Studies in International Culture: Map Appreciation I Guided Independent Study

Spring Semester:

Introduction to Applied Physics, Materials & Energy Engineering Introduction to Chemical & Biological Industries Introduction to Production Engineering English Communication in Environmental Issues Environmental Systems Analysis and Planning Field Seminar on Environmental Studies Introduction to Biodiversity Conservation Projects Low Carbon Cities Studies Theory of Environmental Resources Management Water & Waste Management Policies Advanced Lectures on Quantum Information Perspectives in Mathematical Sciences Clinical Practice (Medicine) Basic Research Laboratory Experience (Medicine) Public Health Research Laboratory Experience (Medicine) Japanese Culture: Language and Communication I Introduction to Sociolinguistics b Studies in International Culture: Map Appreciation II Comparative Studies in Constitutional Law Comparative Studies in Jurisprudence II Political Systems Professional Studies in International Law Studies in Jurisprudence: Law as Political Theory II (S~A) Regular Courses open to degree-seeking students (*J)

(*J) = Courses taught in Japanese requiring at least level 2/N2 of the Japanese Language Proficiency Test (JLPT) (*G) = Lectures/seminars restricted to graduate students

2012-2013
16. (Only for those applicants intending to conduct research whilst at Nagoya University) Name of the faculty member by whom you wish to be supervised, or with whom you have already been in contact. NB. NUPACE cannot guarantee that the specified faculty member will be assigned as your academic supervisor. Faculty members name: Dept: School : at Nagoya U.

I, the undersigned, certify that the above statements are true and accurate, and hereby apply to participate in the Nagoya University Program for Academic Exchange. Applicant's signature: Date:

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Contract

I, , upon being admitted to the Nagoya University Program for Academic Exchange (NUPACE) hereby promise to obey the laws of Japan and the regulations laid down by the Japanese government concerning the conduct of students coming from abroad. I am fully aware that a serious violation of these laws and regulations may result in my expulsion from the University and deportation from the country. Moreover, I do not hold the University responsible for my personal conduct nor for my personal debts nor for fines imposed on me for violations of laws. Finally, if I am a recipient of a Student Exchange Support Program Scholarship for Short-term Study in Japan, I promise to abide by the provisions set out in that scholarship.

Applicant's signature:

Date:

2012-2013
Nagoya University School/Department List
To be used as a reference for question 8 on the NUPACE Application Form.

Agricultural Sciences: Economics: Education: Engineering:

Undergraduate Students: Schools Departments/Majors

Informatics & Sciences:

Law: Letters:

Medicine: Science:

Applied Biosciences; Bioresource Sciences; Bioenvironmental Sciences Business Administration; Economics Human Developmental Sciences (Lifelong Education and Development; School Education and Information Science; International Education and Culture; Human Psychology; Counselling and Psychotherapy) Chemical and Biological Engineering; Civil Engineering and Architecture; Electrical, Electronic and Information Engineering; Mechanical and Aerospace Engineering; Physical Science and Engineering Natural Science Informatics (Environmental Materials; Complex Studies; Mathematical Science); Social and Human Science Informatics (Geography and Sociology; Juristic, Political and Economic Studies of Environment; Psychology and Cognitive Neuroscience; Studies on Media and Society) Law and Political Science Aesthetics and Art History; Archaeology; Asian History; Chinese Literature; Chinese Philosophy; Classics; English Linguistics; English and American Literature; French Literature; Geography; German Literature; Indian Studies; Japanese History; Japanese Linguistics; Japanese Literature; Linguistics; Philosophy; Psychology; Sociology; Western History Health Sciences (Medical Technology; Nursing; Occupational Therapy; Physical Therapy; Radiological Technology); Medicine Biological Science; Chemistry; Earth and Planetary Sciences; Mathematics; Physics

Applied Molecular Biosciences; Bioengineering Sciences; Biological Mechanisms and Functions; Biosphere Resources Science Economics: Industrial Administration Systems; Socio-economic Systems Educ. and Human Development: Educational Sciences (Lifelong Education and Development; School Education and Information Sciences; Foundations of Education and Human Development; Higher Education; Sports Science for Lifelong Physical Activity); Psychology and Human Development Sciences (Psychological Science; Human Development and Clinical Psychology; Sports Behavioural Sciences) Engineering: Aerospace Engineering; Applied Chemistry; Chemical Engineering and Biotechnology; Civil Engineering; Electronical Engineering and Computer Science; Materials, Physics and Energy Engineering; Mechanical Science and Engineering Environmental Studies: Earth and Environmental Sciences; Environmental Engineering and Architecture; Social and Human Environment Information Science: Complex Systems Science; Computer Science and Mathematical Informatics; Information Engineering; IT Professionals; Media Science; Systems and Social Informatics International Development: International Communication; International Co-operation Studies; International Development Languages & Cultures: Japanese Language & Culture; Media Professional Studies; Multicultural Studies Law: Combined Graduate Programme in Law & Political Science; JD Programme for Legal Practice (Nagoya University Law School) Letters: Aesthetics and Art History; Anthropology and Ethnology; Archaeology; Asian History; Chinese Literature; Chinese Philosophy; Classics; Comparative Religious Studies; English Linguistics; English and American Literature; French Literature; German Literature; Indian Studies; Japanese Culture; Japanese History; Japanese Linguistics; Japanese Literature; Linguistics; Philosophy; Japanese Thought and Folklore; Western History Mathematics: Mathematics Medicine: Cell Information Medicine; Function Construction Medicine; Health and Community Medicine; Integrated Molecular Medicine; Medical Science; Medical Science/Medical Administration; Nursing; Radiological and Medical Laboratory Sciences; Physical and Occupational Therapy Science: Biological Science; Material Science; Particle and Astrophysical Science

Graduate Students: Schools Departments

Bioagricultural Sciences:

2012-2013
Confidential Reference Form
To be signed by the applicant: I hereby waive my right to read this reference form, which will be entered into my file at the NUPACE Office, Nagoya University. If at any time I wish to withdraw this waiver, I may do so and I authorise the NUPACE Office to return this reference to the author at that time. Applicant's signature: Date:

To be completed by the referee: NB. This reference should be completed by a faculty member in an academic field closely related to the applicants major. Name of applicant: 1. How long have you known the applicant? In what capacity?

2.

Please rate the applicants academic ability in comparison with students at the same level of study. Top 5% Top 10% Top 25% Top 40% Other

3.

Please rate the applicant in the following areas, using an A~D scale (A = outstanding; B = good; C = average; D = below average): Motivation: Creativity: Maturity: Social Skills: International Outlook:

4.

Please give your candid opinion regarding the applicant's academic performance, character and adaptability. Use a separate sheet of paper, if necessary.

Signature: Full Name <please print>: Title/Position: Department/University: Contact Details: 1) Tel/Fax: 2) E-mail:

Date:

NB. After completing this form, insert it into an envelope, seal and sign your name over the seal. The envelope should be sent either to the applicant or to your institutions International Office, according to request.

2012-2013

1.

Language Proficiency
Name: ( ) ( )

family name

Chinese character(s)

given (including middle) name(s)

Chinese character(s)

Native Language: NUPACE requires exchange students to be proficient in EITHER English OR Japanese. Unless they attend universities where English is the language of instruction, non-native English speakers must possess a TOEFL score of 550 <CBT = 213; iBT = 79>, an IELTS overall band score of 6.0, a TOEIC score of 780, or the equivalent. Students intending to take regular university courses instructed in Japanese must possess Level 1/N1 of the Japanese Language Proficiency Test, or the equivalent. Applicants should enclose copies of the score-sheets of these internationally recognised tests in their application packages.

1.

English Language Ability:

If English is not your native language, please indicate how many years of English language instruction you have had. Total of years

2.

State the name of any internationally recognised English language examination (e.g., TOEFL, IELTS, TOEIC) taken, and scores obtained: Name of Examination: Components: Score<s>:

1. 2. 3.

Japanese Language Ability:

Do you intend to take a Japanese language course at Nagoya University? Yes Yes Name of School(s) No No Period of Study Textbook(s) Lessons completed ~ ~ ~ ~ Have you previously studied Japanese? Please answer the following questions regarding the Japanese courses you have taken:

4.
5.

Approximately how many Chinese characters (kanji) can you read?

Kanji

If you have passed the Japanese Language Proficiency Test (JLPT), please indicate the level and score that you obtained: 1) 1-kyuu 1) N1 2) 2-kyuu 2) N2 3) 3-kyuu 3) N3 4) 4-kyuu 4) N4 5) N5 Score: Score:

2012-2013

Name:

Health Certificate
Date of Birth: / /

Please answer the questions below by checking the appropriate box, before submitting to a physician for your physical examination. 1. List any diseases, disorders or injuries that you have had in the past five years?

2.

Have you received any counselling/undergone any treatment for mental health-related symptoms in the last five years? If yes, please specify. Yes/No Do you have any allergies to foods, plants or animals? Please specify. Yes/No

3.

4.

Have you ever had an adverse reaction to medication? Please specify.

Yes/No

5.

Are you taking medication now? Please specify.

Yes/No

To the Physician:

Please review the applicant's medical history and complete the information below, giving details concerning any positive indications. If there are any abnormalities in the following systems, circle + and explain in detail. 1. Head/Ears/Nose/Throat 2. Respiratory 3. Cardiovascular 4. Eyes 5. Genitourinary Physicians Comments:
/ / / / /

6. Musculoskeletal 7. Metabolic/Endocrine 8. Neuropsychiatric 9. Skin

/ / / /

After reviewing the applicant's medical history and physical condition, I believe him/her to be in good physical and mental health, free of any chronic conditions, disorders or contagious diseases, and capable physically and mentally of completing a one to two semester term of study in a Japanese university. Physician's signature: Physician's name <please print>: Address: Contact Details: 1) Tel/Fax: 2) E-mail: Date:

2012-2013
Personal Data Sheet
Information provided on this form will only be used for the purpose of admission correspondence, immigration application procedures, and in cases of emergency. 1. 2. 4. Name: ( 3. ) ( /
month day

family name

Chinese character(s)

given (including middle) name(s)

Chinese character(s)

Sex: Male / Female Place of birth:

(1) Country:

Date of birth:
year

) (2) State/Province: (
Chinese character(s)

( )

Chinese character(s)

Chinese character(s)

(3) City/Town:

5. 6.

Country of citizenship: Mailing address for all correspondence:

Tel/Fax: E-mail: 7. Permanent Address (if different from above):

Tel/Fax: E-mail: 8. Passport information:

(1) Number: (3) Date of issue:
year

(2) Issuing Authority:

/
month

/
day

(4) Date of expiration:

year

/
month

/
day

9.

Nearest Japanese Embassy/Consulate:

2012-2013

10. Past entry into/stay in Japan:

Yes,

time(s) / No
/
year month

Most recent entry:

/
day

to
year

/
month

/
day

NB. Please fill in the exact date of your most recent stay in Japan. This information is required by the Immigration Bureau.

11. Criminal record: Details, if applicable:

Yes / No

12. Family <father, mother, spouse, son, daughter, brother, sister> already residing in Japan:

Yes / No

NB: Students who circle Yes will be asked to provide more details after their application to NUPACE has been accepted. This information is required by the Immigration Bureau.

13. Total period of education <primary school to last year of study completed>: Expected date of graduation:
year

years

/
month

NB: Please make sure that your expected date of graduation corresponds to the date written in Certificate of Enrolment of the Applicant for Student Exchange Support Program (Scholarship for Short-term Study in Japan).

14. Marital status:

Single / Married / Other

15. Will any dependants accompany you to Japan?) Yes / No Name Relationship to applicant

16. Religion, if any: 17. Person to be notified in home country in case of an emergency: Name: Tel/Fax: E-mail: Address (if different from home address): Relationship to applicant:

10